How Are Dental Claims Handled?

Posted on January 25, 2017 in Dental benefit information

If you visit a Delta Dental of Illinois network dentist or assign benefits, you won't have to submit any paperwork – your dentist will submit a claim directly to Delta Dental of Illinois on your behalf after your dental appointment.

On the other hand, if you visit an out-of-network dentist, you may have to submit your own dental claim to Delta Dental of Illinois. In this case, individual members can download an individual claim form and find more information about how to submit a claim by logging into their account at deltadentalil.me. Group members can download a group claim form and find more information about how to submit a claim by logging into their account at deltadentalil.com. If you don't have an account, you can also register for one at deltadentalil.com/create-account. Claims can be mailed to:

Group Dental Claims
Attn: DDIL – Group Claims
P.O. Box 5402
Lisle, IL 60532
Electronic Claims Payor ID: 05030

Individual Dental Policyholder Claims
Attn: DDIL – Individual Claims
P.O. Box 5402
Lisle, IL 60532
Electronic Claims Payor ID: IDIND

After your claim is received, Delta Dental of Illinois will review the paperwork to verify if:

• you are eligible for coverage;
• the services you received are covered by your dental plan;
• your dentist is in-network or out-of-network; and
• all necessary documentation is included to process the claim (e.g., X-rays).

Once the claim is reviewed, Delta Dental of Illinois will notify you or your dentist if further information is needed. If not, claims are typically processed within three business days, depending on your specific dental plan. After the claim is processed, Delta Dental Illinois will pay in-network dentists directly. If you submitted the claim, you will be reimbursed and will pay your dentist.

You can check the status of a claim and find information about past claims for up to 18 months by logging into your account – individual members will visit www.deltadentalil.me and group members will visit www.deltadentalil.com.